Widya Artini
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo Hospital, Jakarta

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Clinical Outcomes of Laser Peripheral Iridotomy in Eyes with Primary Angle Closure Suspect and Primary Angle Closure Faresa Hilda; Astrianda Suryono; Widya Artini
Majalah Oftalmologi Indonesia Vol 41 No 3 (2015): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v41i3.41

Abstract

Background: Primary angle closure glaucoma (PACG) is a leading cause of bilateral blindness worldwide. Laser peripheral iridotomy (LPI) has been proposed as the standard prophylactic option for patients with the risk of developing the spectrum of disease, from primary angle closure suspect (PACS) toprimary angle closure (PAC) then to PACG. We aim to evaluate the effect of LPI on intraocular pressure(IOP), anterior chamber depth (ACD) and angle width, as prophylactic management in PACS and PAC.Methods: Literature search was conducted from MEDLINE database using Pubmed search engine.Inclusion criteria were all studies (interventional and observational) that reported outcomes of LPI onPACS and/or PAC eyes. Exclusion criteria were outcomes of LPI on PACG eyes.Results: There were 8 studies included in this literature review; 4 studies evaluated patients with PACS,1 study evaluated patients with PAC, while 3 studies had compared between PACS and PAC. FollowingLPI, majority of the studies showed a decrease of IOP when compared to baseline. While, 5 studiesevaluated changes of central ACD and majority of those studies indicated deepening of ACD. Fourstudies had assessed the angle width changes after LPI that revealed advancement of angle width.Conclusion: The results of this literature review showed that LPI in PACS and PAC eyes showed decrease of IOP within a specified period, the deepening of central ACD and increase of angle width.Keywords: Primary angle closure suspect, primary angle closure, laser peripheral iridotomy
Comparison of Clinical Outcomes between Phacoemulsification and Laser Peripheral Iridotomy in the Spectrum of Primary Angle Closure Diseases of the Eye Manoa Panjaitan; Widya Artini
Majalah Oftalmologi Indonesia Vol 42 No 2 (2016): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v42i2.81

Abstract

Background: To compare clinical outcome between phacoemulsification and laser peripheral iridotomyin the spectrum of primary angle closure eyes.Methods: A literature review of databases were retrieved online through Pub-med, Clinical Key, andScience Direct, using keywords of ‘primary angle closure’, ‘primary angle closure glaucoma’, and‘acute primary angle closure’. In addition, all literatures involving the use of laser peripheral iridotomy(LPI) or phacoemulsification as a treatment in PAC diseases were included. Publications and journalsbefore the year 2000 were excluded.Results: There were 18 articles that fulfilled our inclusion criteria. All of the studies showed a decreasein IOP following cataract extraction or LPI, compared to baseline. This study also showed that thephacoemulsification group gave a significantly larger angle width increment when compare to LPI.When directly compared between phaco to LPI, the number of topical glaucoma medication was moredecreased in the phaco group, meanwhile the need for additional glaucoma surgery was higher in theLPI group.Conclusion: Phacoemulsification with posterior chamber lens implantation is more effective procedurethan LPI in lowering IOP and preventing IOP rise in long term follow up in PAC diseases. That surgerywill reduce the number of additional glaucoma medication and further glaucoma filtering surgery.Despite of superiority in phacoemulsification treatment, LPI is still the mainstay of initial treatment,especially in PAC eye diseases without cataract.Keywords: spectrum of primary angle closure eye disease, phacoemulsification, laser peripheral iridotomy, angle width